Opioid Prescribing: The Setting Matters, Long-Term Use Less Likely

A Study of Emergency Departments and Prescription Writing Habits

Prescriptions for opioids written for patients in the emergency department are for smaller doses and of shorter duration than are prescriptions written elsewhere, say findings from a study led by Mayo Clinic. The same study concludes that these patients are less likely to become long-term opioid users. According to the authors, the findings refute the perception that the ED setting is predominant for prescribing opioids. Lead author Molly Jeffery, PhD, scientific director at Mayo Clinic division of Emergency Medicine Research, commented, “This idea didn't really fit with the clinical experience of the ED physicians at Mayo Clinic, but there wasn't much information out there to know what's going on nationally.” Dr. Jeffery also noted that the wide variation in prescribing by practice setting could be an indicator that prescribing is not being matched to individual patient needs. “When we see variability on such a large scale, we should worry that some people are not getting the best, most appropriate treatment.” The findings were published earlier this week in the Annals of Emergency Medicine.
 
Researchers examined 5.2 million opioid prescriptions written for both commercially insured and Medicare patients presenting with acute pain in the US from 2009 to 2015. Patients who were issued prescriptions in the ED setting were 44% less likely to receive a greater-than-3-day supply than patients who were prescribed elsewhere. These patients were also 46% less likely to become long-term opioid users, according to the authors. The Mayo team is presently investigating possible drivers of differences between prescribing patterns across practice settings.

Read more about the survey findings.

The journal abstract may be read here.

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